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Concordancia entre resonancia magnética multiparamétrica de próstata y biopsia transrectal de próstata guiada por ecografía

dc.contributor.advisorVillareal Trujillo, Nicolásspa
dc.contributor.advisorCamacho López, Paul Anthonyspa
dc.contributor.authorPáez Lancheros, Edward Giovannyspa
dc.date.accessioned2020-06-26T20:07:47Z
dc.date.available2020-06-26T20:07:47Z
dc.date.issued2019
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1871
dc.description.abstractContexto: Pacientes con antígeno prostático especifico elevado y/o tacto rectal de próstata alterado, tienen indicación de biopsia transrectal de próstata. Este procedimiento conlleva riesgos de complicaciones como infección, sangrado, dolor, retención urinaria, infección, entre otros. Con tasas de detección que varían entre el 30% y el 40%. La aparición de la resonancia magnética multiparamétrica de próstata (RMmp) ha permitido aumentar las tasas de detección, guiar la biopsia a zonas sospechosas y evitar biopsias innecesarias. Metodología y objetivos. Se realizó un estudio retrospectivo observacional. Donde Se se reviso en la base de datos del centro urológico FOSCAL pacientes con sospecha de cancer de próstata y se incluyeron pacientes con RMmp y Biopsia transrectal de próstata entre el enero 2015 a octubre del 2018. Excluyeron paciente con resultado de Patología no valorable, terapia de deprivación androgénica previa a la toma de la biopsia o Resonancia y tratados de cancer de próstata previamente. Se evaluó la concordancia entre el resultado de la biopsia transrectal de próstata y RMmp, en pacientes con sospecha de cáncer de próstata. Resultados: Se incluyeron 157 pacientes, de los cuales 80 (51%) tenían diagnostico de cáncer de próstata. Del total de pacientes 60 (38%) tenia biopsia de próstata previa, y 20 (12.7%) de estos con resultado positiva para Cáncer de próstata (CaP) anterior a la toma de la resonancia. 71 pacientes tenían cáncer de próstata clínicamente significativo (ISUP GG > 2). La tasa de detección de CaP para PI-RADS 1-2 fue del 30%, PI-RADS 3 del 38.5%, PI-RADS 4 71.4% y PI-RADS 5 del 91.3%. Si los limitamos a cáncer de próstata ISUP GG > 2 la tasa de detección se distribuye así PI-RADS 1-2: 24%, PI-RADS 3: 38.5%, PI-RADS 4: 64.3%, PI-RADS 5: 87%. Conclusiones: La RMmP y la clasificación de PI-RADS v 2.0 tiene una tasa alta de detección y de concordancia con la biopsia transrectal de próstata para la identificación de cáncer de próstata en valores de PI-RADS > 4. Adicionalmente, el tener un PI-RADS 4 y 5, se asocia con una mayor posibilidad de cáncer de próstata de alto riesgo ISUP GG > 4 (42 - 73 % VI respectivamente). Llama la atención que el 22.6% de los pacientes clasificados como PI-RADS 2 tenían un cáncer de próstata clínicamente significativo, por lo que se deben seleccionar con cautela a que pacientes evitarle una biopsia con este resultado.spa
dc.description.tableofcontents1. Introducción ………………………………………………………………………..……..……1 2. Justificación ……………………………………………………………….………..…….……2 3. Marco teórico ………………………………………………………..…………………………3 4. Estado del arte ……………………………………………………..………………..…………8 5. Objetivos ………………………………………………………..…………………….………10 5.1 Objetivo general………………………………………………………………..……..……..10 5.2 Objetivos específicos…..……….………………………………..…………….…………….10 6. Metodologia ……………………..……………………..…………….………………………11 6.1 Area tematica……………………..……………………………….…………………………11 6.2 Tipo de estudio……………………..……………………….……………………… ……….11 6.3 Universo……………..……………………………………………………………… ………11 6.4 Población objeto de estudio………………………………………………………………….11 6.5 Población diana………………………………..…………………………………….……….11 6.6 Criterios de inclusión………………………………….…………………………….……….12 6.7 Criterios de exclusión………………………………………….…………………….………12 6.8 Variables dependientes…………………………………………………..………….….…….12 6.9 Variables independientes…………………………….………..…………………….….….…12 6.10 procedimiento…………………………………….………………..…………..…..…….…13 6.11 Depuración de datos y plan de análisis ………….…….……………………..…….………13 7. Consideraciones éticas …………………………….….……………..………………….…….14 8. Resultados ……………………..………………….………………….………………….……15 9. Discusion ……………………..…………………………………..….…….…………………25 10. Conclusiones ……………………..……………………….…………………………………29 11.Referencias bibliografias ……………………..……………………….………………….…..30 12. Anexos ……………………..……………………….………………………………….…….34spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.titleConcordancia entre resonancia magnética multiparamétrica de próstata y biopsia transrectal de próstata guiada por ecografíaspa
dc.title.translatedAgreement between multiparametric magnetic resonance imaging of the prostate and ultrasound-guided transrectal biopsy of the prostateeng
dc.degree.nameEspecialista en Urologíaspa
dc.coverageBucaramanga (Santander, Colombia)spa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.programEspecialización en Urologíaspa
dc.description.degreelevelEspecializaciónspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsProstateeng
dc.subject.keywordsHigh-density ultrasound directed transrectal ultrasoundeng
dc.subject.keywordsMagnetic resonanceeng
dc.subject.keywordsMedicineeng
dc.subject.keywordsUrologyeng
dc.subject.keywordsInvestigationseng
dc.subject.keywordsAnalysiseng
dc.subject.keywordsInfectioneng
dc.subject.keywordsMultiparametric resonance imaging of the prostate (mpMRI)eng
dc.subject.keywordsData system lesion index and prostate imaging information (PI-RADS)eng
dc.subject.keywordsClinically significant prostate cancer (CaCS)eng
dc.subject.keywordsTransrectal prostate scan (TR)eng
dc.subject.keywordsProstate specific antigen (PSA)eng
dc.subject.keywordsScore by groups of the international society of urological pathology (ISUP)eng
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2spa
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dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000323578*
dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001624843*
dc.contributor.cvlacCamacho López, Paul Anthony [0000323578]
dc.contributor.googlescholarhttps://scholar.google.es/citations?hl=es&user=-u8d7_QAAAAJ*
dc.contributor.googlescholarCamacho López, Paul Anthony [OvqUoOAAAAAJ]
dc.contributor.orcidhttps://orcid.org/0000-0002-6233-9582*
dc.contributor.orcidCamacho López, Paul Anthony [0000-0002-6233-9582]
dc.contributor.scopushttps://www.scopus.com/authid/detail.uri?authorId=16047325700*
dc.contributor.scopusCamacho López, Paul Anthony [16047325700]
dc.contributor.researchgatehttps://www.researchgate.net/profile/Paul_Camacho_Lopez*
dc.contributor.researchgateCamacho López, Paul Anthony [Paul_Camacho_Lopez]
dc.subject.lembPróstataspa
dc.subject.lembEcografía transrectal eco dirigida de alta densidadspa
dc.subject.lembResonancia magnéticaspa
dc.subject.lembMedicinaspa
dc.subject.lembUrologíaspa
dc.subject.lembInvestigacionesspa
dc.subject.lembAnálisisspa
dc.description.abstractenglishContext: Patients with elevated specific prostate antigen and / or altered transrectal prostatectomy, frequently undergo prostate biopsy guided by transrectal ultrasound. This procedure has complications such as infection, bleeding, pain, urinary retention and infection. The emergence of multiparametric prostate magenta resonance has allowed the interpretation to be improved and to evaluate which men could avoid the biopsy Methodology and objectives. A retrospective observational study was conducted, which assessed the agreement between the result of transrectal prostate biopsy with the PI-RADS v 2.0 classification of multiparametric prostate resonance in patients with suspected prostate cancer. Results: A total of 157 patients were selected with inclusion criteria, of which 80 (51%) of 157 patients had a diagnosis of prostate cancer. Of the patients with the diagnosis of prostate cancer 71 (89%) of them had clinically significant prostate cancer (ISUP G G > 2). The agreement between PIRADS v2 and CAPCS was 64.3% and 87% with PI-RADS 4 and 5 respectively had CAPCS. 76% of patients with negative biopsy and non-significant prostate cancer had PI-RADS 2. Conclusions: We found that the mpMRI has a high concordance in the identification of prostate cancer in PI-RADS > 4, this agreement is comparable to other studies. Additionally, having a PIRADS 4 and 5, that would be associated with having a high-risk prostate cancer between 40 and 70% of the patients undergoing the study.eng
dc.subject.proposalInfecciónspa
dc.subject.proposalResonancia multiparamétrica de próstata (RMmp)
dc.subject.proposalÍndice de lesiones del sistema de datos e información de imágenes de próstata (PI-RADS)
dc.subject.proposalCáncer de próstata clínicamente significativo (CaCS)
dc.subject.proposalTacto transrectal de próstata (TR)
dc.subject.proposalAntígeno prostático específico (APE)
dc.subject.proposalPuntuación por grupos de la sociedad internacional de patología urológica (ISUP)
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.contributor.apolounabCamacho López, Paul Anthony [paul-anthony-camacho-lópez]
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.description.learningmodalityModalidad Presencialspa
dc.contributor.linkedinCamacho López, Paul Anthony [paulcamachomdepi]


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